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8-K
HANGER, INC. filed this Form 8-K on 06/23/2017
Entire Document
 

 

Form of Reverse Side of Right Certificate — continued

 

FORM OF ELECTION TO PURCHASE

 

(To be executed if the holder desires to exercise
the Rights represented by the Right Certificate.)

 

To: HANGER, INC.

 

The undersigned hereby irrevocably elects to exercise                Rights represented by this Right Certificate to purchase the Preferred Shares issuable upon the exercise of such Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares (or other securities) be issued in the name of:

 

Please insert social security
or other identifying number

 

(Please print name and address)

 

 

If such number of Rights shall not be all of the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining of such Rights shall be registered in the name of and delivered to:

 

Please insert social security
or other identifying number

 

(Please print name and address)

 

 

Dated:

 

 

 

 

 

 

 

 

 

 

Signature

 

Signature Guaranteed:

 

Signatures must be guaranteed by a member or participant in the Securities Transfer Agent Medallion Program, the New York Stock Exchange Medallion Signature Program or the Stock Exchange Medallion Program.

 

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